Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality: Part I—All Cancers and Lung Cancer and Part II—Colorectal, Prostate, Breast, and Cervical Cancers

Abstract

<jats:p>We analyzed socioeconomic, rural-urban, and racial inequalities in US mortality from all cancers, lung, colorectal, prostate, breast, and cervical cancers. A deprivation index and rural-urban continuum were linked to the 2003–2007 county-level mortality data. Mortality rates and risk ratios were calculated for each socioeconomic, rural-urban, and racial group. Weighted linear regression yielded relative impacts of deprivation and rural-urban residence. Those in more deprived groups and rural areas had higher cancer mortality than more affluent and urban residents, with excess risk being marked for lung, colorectal, prostate, and cervical cancers. Deprivation and rural-urban continuum were independently related to cancer mortality, with deprivation showing stronger impacts. Socioeconomic inequalities existed for both whites and blacks, with blacks experiencing higher mortality from each cancer than whites within each deprivation group. Socioeconomic gradients in mortality were steeper in nonmetropolitan than in metropolitan areas. Mortality disparities may reflect inequalities in smoking and other cancer-risk factors, screening, and treatment.</jats:p>

Descripción epidemiológica de la mortalidad por cáncer de mama en mujeres en Chile

“…Si bien se ha estudiado la etiología del cáncer de mama a nivel individual, aún es necesario abordar cuáles son las causas de la enfermedad a nivel poblacional, que no necesariamente serán las mismas y el análisis ecológico contribuye a dilucidar esta pregunta 36 . Las asociaciones encontradas han sido descritas en la literatura internacional, esto es, la relación del cáncer de mama con el grado de urbanización y con mayor educación 4,37 . Esto podría explicarse por la mayor prevalencia de factores de riesgo de tipo hormonal en mujeres residentes en comunas urbanas y por diferencias en las etapas de la transición epidemiológica a lo largo del país.…”

“…Esto podría explicarse por la mayor prevalencia de factores de riesgo de tipo hormonal en mujeres residentes en comunas urbanas y por diferencias en las etapas de la transición epidemiológica a lo largo del país. No obstante, en países desarrollados este mayor riesgo en áreas urbanas se ha trasladado al sector rural, debido a factores relacionados con la detección y acceso a tratamiento oportuno 37 .…”

Racial Disparities in Survival After Diagnosis of Prostate Cancer in Kentucky, 2001-2010

“…Du et al (2011);White et al (2011);Taksler, Keating, and Cutler (2012);and Singh, Williams, Siahpush, and Mulhollen (2011) have all reported shorter survival in African American men after the diagnosis of PC. In these studies, the racial gap in survival remained after adjusting for known predictors of cancer survival.…”

Counties eliminating racial disparities in colorectal cancer mortality

“…39 CRC mortality across the United States is associated with neighborhood-level socioeconomic deprivation. 40 In Texas, late detection of cancer was associated with the Well-Being Index of socioeconomic deprivation, as well as lack of health insurance, physician shortage, and Hispanic ethnicity. 41 In a national study, individuals with the least education were found to have significantly higher CRC death rates for each racial ethnic group in virtually all states.…”